• 대한간호학회지
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• 제8권1호
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• pp.85-98
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• 1978

This study was designed to investigate the elderly people's attitude toward death for the purpose of identifying the issues needed in the planning of health management and care activities for the aged. The total number of subjects in this study was 354 elderly people who were accommodated in house for elderly people (185) and school for elderly people (169). The scale for the attitude toward death of aged persons as an instrument of this study was mainly constructed with reference to Schneidman's attitude questioners toward death modified of adjust the Korean cultural characteristics and attitudes concerning death. Theresultsofthisstudywereasfollows: - 1. Out of total 45.8% of the respondents consider that death is a natural phenomena and ending of life. The responses on the meaning of death appeared differently : non-religions (48.1%) and oriental religions (50.3%) consider death as a natural phenomena however western religions (47.4%) consider that death is God's call. This difference was statistically significant. (x$^2$= 56.6419. df = 10. p<0.01). Respondents with a spouses (52.4%) think death is a natural phenomena opposed to respondent without spouses (33.3%). This was statistically significant. (x$^2$= 14.7134. df= 5 p<0.05). 2. Respondents in the house for aged persons (51.9%) replied. They do not wanted death because it meant a separation from their family as compared to those from school for aged persons (26.0%). 57.9% responded that they want to be told when death is confronted. 3. 51.2% of the respondents replied that the main factor to influence their attitude toward concept of death was the dying of their friends & relatives. 79.9% of respondents expressed that wished to die. The main reason for dying was economic shortage (28.3%). 4. 70.1% of the respondents want their body to be hurried while only 1.1% of the respondents want to donate their body to a medical research. 5. Over two thirds of the respondents replied that they do not believe in a life in heaven or that they will be rebirth. 6. The questioners of this study stimulated 56.8% of the respondents to feel that they should spend the leu of their life more effectively and 15.5% of the respondents felt it gave them the opportunity to think about their death seriously.

• Yonsei Medical Journal
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• 제59권9호
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• pp.1064-1071
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• 2018

Purpose: To explore the influence of S100 calcium binding protein A4 (S100A4) knockout (KO) on methionine-choline-deficient (MCD) diet-induced non-alcoholic fatty liver disease (NAFLD) in mice. Materials and Methods: S100A4 KO mice (n=20) and their wild-type (WT) counterparts (n=20) were randomly divided into KO/MCD, Ko/methionine-choline-sufficient (MCS), WT/MCD, and WT/MCS groups. After 8 weeks of feeding, blood lipid and liver function-related indexes were measured. HE, Oil Red O, and Masson stainings were used to observe the changes of liver histopathology. Additionally, expressions of S100A4 and proinflammatory and profibrogenic cytokines were detected by qRT-PCR and Western blot, while hepatocyte apoptosis was revealed by TUNEL staining. Results: Serum levels of aminotransferase, aspartate aminotransferase, triglyceride, and total cholesterol in mice were increased after 8-week MCD feeding, and hepatocytes performed varying balloon-like changes with increased inflammatory cell infiltration and collagen fibers; however, these effects were improved in mice of KO/MCD group. Meanwhile, total NAFLD activity scores and fibrosis were lower compared to WT+MCD group. Compared to WT/MCS group, S100A4 expression in liver tissue of WT/MCD group was enhanced. The expression of proinflammatory ($TGF-{\alpha}$, $IL-1{\beta}$, IL-6) and profibrogenic cytokines ($TGF-{\beta}1$, COL1A1, ${\alpha}-SMA$) in MCD-induced NAFLD mice were increased, as well as apoptotic index (AI). For MCD group, the expressions of proinflammatory and profibrogenic cytokines and AI in KO mice were lower than those of WT mice. Conclusion: S100A4 was detected to be upregulated in NAFLD, while S100A4 KO alleviated liver fibrosis and inflammation, in addition to inhibiting hepatocyte apoptosis.

• 사상체질의학회지
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• 제36권1호
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• pp.13-30
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• 2024

Objectives This study aimed to analyze the influence of various sleep-related factors that affect sleep quality by each Sasang type. Methods A total of 400 subjects were included for this study, 108 males and 292 females. Sasang type was diagnosed using the SCAT. Then, the characteristics of each Sasang type were analyzed using HRV, DITI, and PSQI, PSS, and SDFI questionnaires. Logistic regression analysis was used to predict sleep-related factors that affect sleep disorders by Sasang types. Results This study shows that the pathophysiological characteristics for stress and digestive function of each Sasang type can differentiate sleep management through a logistic regression model including subscales of PSS and SDFI. Stress had no effect on the occurrence of sleep disturbance within only So-Eum, since the stress level is originally high in the So-Eum regardless of sleep quality. Rather, decreased appetite and poor eating habits had a significant impact on the decline in sleep quality. In addition, poor digestion and eating habits in So-Yang had a greater impact and poor digestion in Tae-Eum had a greater impact on the decline in sleep quality. Conclusion The stress and subscales of digestive function provide differentiated sleep management in So-Yang, Tae-Eum, and So-Eum types. The individualized sleep management for each Sasang type with statistically validated PSS and SDFI would be useful for sleep-related experts planning safe and effective person-centered health care as well as for Western clinicians who want to incorporate Sasang typology into their treatments as integrative medical technique in the future.

• 대한한의학방제학회지
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• 제19권1호
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• pp.207-217
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• 2011

Objectives : In a previous study, we have shown that Gagam-Gongjin-Dan(GGD) has an inhibitory effect on the ovalbumin-induced immune responses and a hepatoprotective effect on actaminophen-induced liver injury in Balb/c Mice. However, the possible anti-inflammatory effect of GGD extract for inflammatory mediators was not reported. Therefore, the purpose of this study was to investigate an inhibitory effects of GGD extract against lipopolysaccharides(LPS) induced inflammatory mediators in mouse peritoneal macrophages. Methods : GGD extract was prepared by extracting with methanol for 7 days. The extract was freeze-dried following filtration through vacuum distillation system. Accumulated nitrite, an oxidative product of nitric oxide(NO), was measured in the culture medium by the Griess reaction. The levels of prostaglandin $E_2(PGE_2)$, interleukin-$1{\beta}$(IL-$1{\beta}$), tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) were measured by enzyme-linked immunosorbent assay. The expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2(COX-2) were measured by Western blot analysis. Results : GGD extract (50-$400\;{\mu}g$/ml) per se had no cytotoxic effect in LPS-stimulated peritoneal macrophages. GGD extract dose-dependently reduced NO, $PGE_2$, IL-$1{\beta}$ and TNF-${\alpha}$ production and COX-2 activity caused by stimulation of LPS. The levels of iNOS and COX-2 protein expressions were markedly suppressed by the treatment with GGD extract in a dose dependent manner. Conclusions : These results suggest that GGD extract has an anti-inflammatory effect against LPS-induced inflammatory mediators in peritoneal macrophages, these properties may contribute to inflammation disease care.

• 척추신경추나의학회지
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• 제11권1호
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• pp.53-64
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• 2016

Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

• 의료법학
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• 제18권1호
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• pp.297-341
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• 2017

2016년에 선고된 의료관련 판결들을 법원도서관 검색사이트와 법률전문기사를 통해 검색하여 다음과 같이 분석 소개하였다. 의료민사와 관련하여 (1) 제왕절개 수술 시 불임수술도 함께 청약하였으나 불임수술은 하지 아니한 사례에서는 의료계약체결과정에 판시의 결여에 대한 아쉬움과 함께 침해되는 권리 및 배상범위를, (2) 의료과실 추정 관련에서는 과실추정법리의 한계를 벗어난다는 점과 한의사의 협진의무를 매우 높은 정도로 요구했다는 점을, (3) 병원측 책임을 100% 인정한 사건에서는 의료행위의 선의성과 불확실성에 대한 간과를 지적하면서, (4) 정신과 환자 관련 사고에서 병원책임을 인정한 사건들을 관련판결과 함께 소개하였다. 의료형사와 관련해서는 치과의사의 안면 보톡스 시술이 면허범위 내 의료행위인지 여부에 대한 대법원 전원합의체 판결을 다수의견의 해석이 법문언의 가능한 범위 내에 있는지의 관점에서 분석하였다. 그리고 의료행정과 관련하여 (1) 의료인이 다중으로 의료기관을 운영한 경우 이에 대하여 국민건강보험법상 환수처분을 할 수 있는지 여부를 다중으로 운영된 의료기관이 의료법에 따라 개설된 의료기관에 해당하는지의 관점에서 분석하고, (2) 임의비급여진료 동의의 전제로서 설명의무에 관한 판결을 설명의 대상, 정도, 주체의 면에서 검토하였다. 마지막으로 정신질환자 보호입원 사건에서 제청된 보호의무자 2인의 동의와 정신건강의학과전문의 1인의 진단에 의하여 정신질환자를 입원시킬 수 있도록 한 정신보건법 제24조에 대하여 위헌법률심판결정에 대해 소개하면서 개정된 정신보건법에 대한 문제점을 아울러 제시하였다.

• 대한예방한의학회지
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• 제20권1호
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• pp.55-64
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• 2016

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

• Safety and Health at Work
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• 제13권3호
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• pp.263-268
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• 2022

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.

• Tuberculosis and Respiratory Diseases
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• 제58권1호
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• pp.31-42
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• 2005

배 경 : peroxiredoxins는 거의 모든 생명체에 공통적으로 보존되어 있으며, 최근에 발견된, 특이한 peroxidases로 인체에서 6가지 동위효소가 알려져 있으며, 산화스트레스에 대한 방어역할을 담당하고, $H_2O_2$신호전달 과정에서 중요한 조절 역할을 한다. peroxiredoxin은 $H_2O_2$ 처리 과정 중에서 자신이 산화되어 불활성화 되는데, 산화된 후 다시 재생되는 것으로 보고되나 그 생리적은 의미는 분명하지 않다. 이에 저자들을 폐상 피세포주, 대식세포주, 폐포모세혈관 내피세포주 및 기타 섬유모세포주 들에서 $H_2O_2$ 에 의한 Prx의 산화과정과 재생을 알아보고자 하였다. 방 법 : 수술 환자에서 적출한 정상 폐조직과, 세포주로는 평상시 산화 스트레스에 노출이 많을 것으로 예상되는 세포들로써, 폐포상피세포의 I 형 및 II 형 세포에서 기원한 A549, WI 26, Raw 264.7, Rat2,및 폐포 모세혈관 내피세포주 등을 이용하여 이를 $50{\mu}M$. $100{\mu}M$, $500{\mu}M$ 의 $H_2O_2$로 산화시켜 불활성화 한 후, 추적관찰 하였으며, 시간대 별로(0. 10, 30, 60, 120, 240, 480 분) 수확하여, 이를 1차원 non-reducing SDS-PAGE 및 2차원 전기영동로 분리 후, silver stain 과 Western blot으로 분석 하였다. 결 과 : 1. 실험에 사용된 모든 세포주에서, $H_2O_2$ 농도에 비례하여 peroxiredoxin I, II, III 의 불활성화를 관찰할 수 있었고, 10분에 최고로 불활성화되었다. 2. 산화된 이후, 30분경부터 peroxiredoxin 의 재생이 관찰되기 시작 하였으며, 2시간 이후부터 확연하였다. 3. 다시 재생된 peroxiredoxin은 $H_2O_2$투여로서, 다시 불활성화되어, 재생된 Prx 가 활성을 지닌 단백질임을 알 수 있었다. 4. 재생의 속도는 사용된 세포주마다 차이가 있었으며 (A549 >Raw 264.7 >$Rat_2$ >WI26), 단백질 합성억제제인 cycloheximide ($10{\mu}g/ml$) 존재 하에서도 변함 없이 관찰되었다. 결 론 : 세포 내에는 산화되어 불활성화된 peroxiredoxin을 재생하는 체계가 존재 하며, 이는 활성부위 cysteine을 갖는 다른 단백질에도 공통적으로 적용될 수 있는 분자 스위치일 가능성이 높으며, 산화에 의한 신호전달과정이나, 질병 모델에서 Prx 단백의 재생 체계의 이상과 병인에 관한 추가적인 연구가 필요할 것으로 사료된다.

• 대한예방한의학회지
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• 제19권1호
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• pp.23-33
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• 2015

Objective : This study aimed to develop a new category system of Yanseng(養生) for traditional Korean Medicine in order to prepare the ground for organizing the resources of Yangseng systematically. Method : We reviewed the existing medical books containing Yangseng contents. Based on the experts' consensus, we drew the new category system of Yangseng in consideration of a national trait of Korea and use of Yanseng in modern society. Results : First, We devided Yangseng category into two parts: methods and applications. Methods are divided into 5 parts: mind, diet, herb, Doinangyo(導引按蹻), life. A broad use of herbs in daily life is a national trait of Korea. Doinangyo contains relaxation methods like breathing, massages and exercises like Qigong and is also very popular way to maintain health in modern western society. Applications are divided into 6 parts: type of constitution, life cycle, seasons, type of symptoms and signs, type of Mibyung(未病) and diseases. We drew this 6 parts in consideration of use in the field of health care. Conclusion : The new category system of yangseng is based on existing theories and reflects Korean national trait and use of Yanseng in modern society. We hope this new category system play a role of foundation for organizing the resources of Yangseng systematically.